Brief Answer: Do not worry, these are common issues Detailed Answer: Hi XXXX, Welcome to healthcaremagic. I understand your problem very well. Do not worry, these are very common issues in Gynecology practice. The most common cause of these symptoms is PCOD. It happens due to stress and minor hormonal imbalances in different hormones that compound and lead to this problem. The main issue with this is that normally in every menstrual cycle one female egg is produced and released by the ovary. In PCOD, this does not happen. Either the eggs are not produced or they are not released and trap in the ovary. This again leads to hormonal imbalances and again ovum trapping. Another reason for this may be thyroid dysfunction. Usually raised thyroid leads to irregular cycles, but even low thyroid may cause irregular menses. You have already got treated for thyroid. It takes some times and repeated testing to determine the proper dose of thyroid. So if you have started taking novothyral for three months, thyroid levels will need to be tested to see if TSH and ft4 have returned to normal levels. If they are normal then continue this dose, if no then readjustment of the dose is needed. Other causes of irregular periods may be ovarian cysts or increased prolactin hormone levels [check if this has been tested]. I suggest that you get an ultrasound examination done to look for uterus and ovaries. If there is PCOD, you will need to do the PCOD profile testing on day 3 of menses [ may need to induce menses with progesterone for the test]. Depending upon the affected hormone treatment will be started. Having said this, it is difficult to get cycle control with PCOD. The drugs that you have received until now [jasmin pills and orgamentril] both contain hormones that replace our body hormones. So the menses that you were experiencing were due to these hormones causing effects in the body and not allowing your own hormones to act. As soon as these hormones are stopped you return to your original state of irregular periods. If it is PCOD it is difficult to treat and get regular cycles. If hormones are found to be abnormal then they can be treated specifically. Sometimes hormone testing reveals normal results in PCOD. The only cause of concern is non production and release of the female egg. Treatment for this must be done only when attempting pregnancy. So if you plan to get married and have children it is better you do it early. Drugs to induce ovulation will help at that time. Sometimes laparoscopic drilling also helps. Pregnancy tends to cure the disease in many women. You have been advised this earlier also as appears in your query. regarding the irregular menses, if they are due to PCOD, we are not worried if menses occur atleast 4 times in one year. If less than 4 times, a progesterone for last 7 days of the cycle is used to induce bleeding as you have been receiving until now. So get an ultrasound [ transvaginal or TVS scan] and a PCOD profile as well as prolactin done and let me know. Do not worry, these are very common issues. Hope this satisfies your query. Thanks for using HCM. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist

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